Evaluation of internal fixation techniques for condylar head fractures: A finite element analysis and comparison
Evaluation of internal fixation techniques for condylar head fractures: A finite element analysis and comparison
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DOI：
10.1016/j.oooo.2021.08.028
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发表时间：
2022-04-14
影响因子：
2.9
通讯作者：
Yang, Chi
中科院分区：
文献类型：
--
作者：
Bu, Lingtong;Chen, Qin;Yang, Chi
目标.本研究通过有限元分析（FEA）评估了不同螺钉技术治疗髁状突头骨折（CHF）（P接近M型骨折，根据AO分类2014保留外侧极）的最佳稳定性，并为临床治疗提供生物力学基础。评估了四种CHF固定模型：（A）单个双皮质螺钉，（B）2个双皮质螺钉，（C）通过2孔钛板插入1个双皮质螺钉和1个单皮质螺钉（用作定位螺钉），以及（D）通过钛板插入2个双皮质螺钉。计算应力（FEA）以测量机械性能。A和C的位移大于B和D。A和C螺钉上的最大应力超过其断裂极限，但B和D是安全的。C和D钛板上的应力是安全的。A组和C组的骨应力大于B组和D组。2枚双皮质螺钉固定可降低植入材料及周围骨组织的应力。钛板进一步缓解了杠杆作用。双皮质螺钉内固定治疗CHF更可靠，术后可早期负重和功能训练。
Objectives. This study evaluated optimum stability of different screw techniques for condylar head fractures (CHF) (P close to an M fracture with the lateral pole preserved according to AO classification 2014) by finite element analysis (FEA) and provided a biomechanical basis for clinical treatment.Study Design. Four CHF fixation models were evaluated: (A) single bicortical screw, (B) 2 bicortical screws, (C) 1 bicortical screw and 1 monocortical screw (used as a positional screw) inserted via a 2-hole titanium plate, and (D) 2 bicortical screws inserted via a titanium plate. Stresses were calculated (FEA) to measure mechanical properties.Results. The displacement for A and C was larger than for B and D. The maximum stress on the screws for A and C exceeded their breaking limit but was safe for B and D. The stress on the titanium plate for C and D was safe. The stress on bone for A and C was larger than for B and D.Conclusions. The 2 bicortical screw fixation reduced the stress on implanted materials and surrounding bone tissue. Titanium plates further alleviated the lever action. Two bicortical screw fixation was more reliable for CHF, and early postoperative loading and functional training can be expected.